Bipolar Type 2: Symptoms, Causes, Diagnosis, Treatment - Verywell Health

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Bipolar disorder is a mental health illness and a type of brain disorder. There are two types, called bipolar 1 disorder and bipolar 2 disorder. Each type has characteristics that distinguish them from one another.

People with bipolar disorder may experience recurring extreme changes in moods that can last for days, weeks, and longer. These moods can fluctuate between feelings of extreme elevations of mood or irritability and feelings of profound sadness or depression.

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Symptoms of Bipolar Type 2 Disorder

Because bipolar disorder can look like other mental health disorders, it is often misdiagnosed. Symptoms of bipolar disorder can appear as depression, anxiety disorders, obsessive-compulsive disorders, personality disorders, and even schizophrenia. Understanding the symptoms of bipolar disorder, and specifically bipolar type 2 disorder, is an important way to ensure an accurate diagnosis and effective treatment.

Symptoms in Diagnostic Criteria

With bipolar type 2 disorder, similarly to bipolar type 1 disorder, episodes of depression are often the first symptoms to be experienced. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides the following criteria for diagnosing depression:

A person with bipolar disorder will experience five or more symptoms during a two-week period, with at least one of the symptoms being 1) depressed mood most of the day nearly every day or 2) loss of interest or pleasure. Additional diagnostic symptoms include:

• Significant weight loss or weight gain or change in appetite nearly every day
• A slowing down of thought and physical movement that is recognizable by others
• Fatigue nearly every day
• Feelings of worthlessness or excessive guilt nearly every day
• Lowered ability to concentrate or indecisiveness nearly every day
• Recurrent thoughts of death or suicide or a planned or attempted suicide

Depression

Many people with bipolar type 2 disorder experience depression throughout most of their illness, which makes it difficult to properly diagnose. If you experience periods of elevated mood or excitability in between depressive episodes, tell a mental health professional to ensure you receive an accurate diagnosis and correct treatment.

Hypomania

The other main distinguishing symptom of bipolar type 2 disorder is hypomania. Hypomania is a period of feeling elated, excited, or having high energy and self-esteem. It can also include increased talkativeness, racing thoughts, and distractibility. Unlike bipolar type 1 disorder, a person with bipolar type 2 does not experience full mania. This means the fluctuations are usually less severe than with bipolar type 1 and might not inhibit a person's ability to function.

To be considered hypomanic, this mood must last most of the day for at least four consecutive days. For mania, the elevated mood must be present for most of the day, last at least one week, and be severe enough to cause marked impairment in functioning, require hospitalization, or have psychotic features present.

People with bipolar disorder often experience depressive episodes frequently throughout the course of their illness.

When Do Bipolar Disorder Symptoms Usually Start?

People with bipolar disorder often start to experience symptoms at a younger age than those who are experiencing depression alone. The average age for someone to experience symptoms of bipolar disorder is 22, and some people have symptoms as teenagers.

Who Is at Risk for Bipolar Type 2 Disorder?

Bipolar disorder is highly genetic. Those with a first-degree biological family member with bipolar disorder are at the highest risk of developing the disorder. Having a family history of bipolar disorder also is a strong predictor of developing it.

Others who should be screened for bipolar disorder include those for whom antidepressants are not effective or that worsen mood symptoms and those who frequently experience depression that is interrupted by periods of feeling "better than good." Also, teenagers between the ages of 13 and 18 who experience frequent depression should be screened for bipolar disorder.

Bipolar disorder is highly heritable, with genetic influences contributing 60%–80% to the risk.

Diagnosis

Bipolar disorders are generally diagnosed by psychiatrists, medical doctors, and licensed mental health professionals. Typically, a primary care physician, therapist, or psychiatrist will ask a series of questions about symptoms. They may use a screening tool, like the Mood Disorder Questionnaire (MDQ) or the Hypomania/Mania Symptom Checklist (HCL-32).

These are considered screening tools, not diagnostic tools. That means they can help a mental health professional identify symptoms of bipolar disorder in a person, but they cannot be used as a sole method for diagnosing the disorder.

Receiving a correct diagnosis is very important in order to get the right treatment plan and medications. When bipolar disorder is misdiagnosed as depression, for example, antidepressants alone may be prescribed. These may not adequately treat the mood symptoms and may actually worsen the overall course of the illness.

Treatment Options

Treatment of bipolar disorder is an ongoing process and must be maintained by a mental health professional to manage symptoms and ensure the person's safety and healthy functioning. Though bipolar disorder is a lifelong illness, medication and mental health therapy can stabilize moods and allow a person to live a healthy life.

The most common types of medications prescribed for bipolar disorders include:

• Lithium
• Depakote (valproate)
• Tegretol (carbamazepine)
• Lamictal (lamotrigine)

In addition to these mood stabilizers, antipsychotic medications are often used. These medications are prescribed by a medical doctor, often a psychiatrist, who can discuss side effects, effectiveness, and symptom management. The exact type of medication prescribed and its efficacy depend on a number of factors.

Summary

Bipolar 2 disorder is a type of mental illness that is characterized by swings in mood that vary between periods of depression and periods of hypomania. Hypomania includes persistently elevated, expansive, or irritable moods and increased energy.

Although the mania in bipolar 2 is less severe compared to bipolar 1, bipolar type 2 disorder is a serious illness that must be diagnosed, treated, and managed by a mental health professional. The depression that is part of this illness can be quite severe and persistent. Left untreated, bipolar disorder can become highly disruptive and can cause significant distress in those affected and their loved ones.

A Word From Verywell

Learning you have bipolar disorder can be scary and overwhelming. If you think you might have bipolar disorder or you already have been diagnosed, know that there is treatment available that can help you manage the illness and live a happy, stable life.

The most important measure you can take for your mental health is be open with your doctor or mental health professional about any periods of high energy, irritability, risk-taking behaviors, or other uncharacteristic behaviors that occur in between episodes of depression.

Receiving a correct diagnosis, beginning treatment right away, and continuing to work with mental healthcare professionals to manage your disorder will help you to feel like yourself again and prevent future disruptive episodes.

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